Anesthesia Coding Alert

Question: How is the billing handled when the anesthesiologist is medically directing one certified registered nurse anesthetist (CRNA) and the CRNA is an independent contractor?

Arizona Subscriber

Answer: Billing will depend on the insurance company. For patients with Medicare, the CRNA will need to reassign their benefits to the individual or group of anesthesiologists. Make sure this is done before the CRNA begins and identify the effective date.

Don’t miss: Previously, CRNAs used CMS-855R to reassign benefits, but Medicare merged the form into CMS-855I. As of Nov. 1, CMS no longer accepts the old form.

Medicaid, on the other hand, varies by state. As a general rule of thumb, if you have an application process for your employed CRNAs, you will likely need to apply that same process for independent contractor CRNAs as well.

For more information on the consolidated CMS-8551/ CMS-855R form, go to www.cms.gov/files/document/consolidated-cms-8551-bulletin.pdf.